RN Case Manager

Job Locations
US-DC

Req No

2018-5052

Type

Contract

Overview

At Peak, we recognize the training and experience that goes into becoming an experienced Case Manager. We know that deep down, helping patients emerge successfully from their inpatient stays isn't just a project for good case managers—it's a rewarding career. Our employees have a unique opportunity to work for some of the nation's top hospitals including teaching facilities and high-acuity level sites.

We provide ongoing training to ensure our employees receive regulatory updates, information on new procedures and guidance on current trends.

Responsibilities

An RN Case Manager must be able to multitask and handle numerous responsibilities throughout eachday. They must also be effective communicators with patients, families, doctors, and insurance providers; capable of understanding and explaining the features of Medicare, Medicaid, and other insurance options. In-depth knowledge of health care services and medical terminology is a requirement as well.

Assess new patients

Update and revise patient health care plans as needed

Educate patients and families about health care plans and options

Make clinical decisions for routine patient care

Accurately document and submit medical records

Demonstrate knowledge in medical care; such as diagnostic procedures, medication, symptoms, and other treatment-related therapies

Provide emotional support to patients and families

Evaluate and determine needs of patients

Review results from medical tests

Implement physician orders and other nursing procedures

Create an environment for open communication

Qualifications

Performs utilization review for a specific patient population. Works jointly with the Hospitalists and PCP’s. Attends daily rounds. Assess and plan interdisciplinary plan of care, providing appropriate utilization of resources and coordinates a safe and timely discharge. Communicates precisely with the social worker in determining the proper plan of care for each patient. Notifies third party payers of clinical updates as defined by individual contracts. Demonstrates knowledge of computer skills and specifically Interqual. Participates on the Utilization Management Committee. Partakes in case conferences as needed. Maintains patient confidentiality as specified by HIPAA regulations. Supports and participates in the development of the Case Management Department. Maintains a daily census of 20-30 patients per day. Call patients after discharged to go home. May provide case management to other hospital areas such as: ED, Outpatient Services and CDIS.

Must have:

A valid professional license within the state of practice, or compact state

BLS from the American Heart Association

Proof of right to work in the United States

Knowledge of Interqual or Milliman guidelines

Preferred:

Case Manager certification preferred

BSN preferred

Peak Health Solutions, an AMN Healthcare company, is an EEO/AA/Disability/Protected Veteran Employer. We encourage minority and female applicants to apply